發(fā)布時(shí)間：2018-03-20 07:00

  本文選題：肺小結(jié)節(jié)　切入點(diǎn)：微彈簧圈　出處：《醫(yī)學(xué)影像學(xué)雜志》2016年06期 　論文類型：期刊論文

【摘要】：目的探討CT引導(dǎo)下定位置入微彈簧圈在肺小結(jié)節(jié)楔形切除術(shù)中的臨床應(yīng)用。方法對(duì)12例肺小結(jié)節(jié)患者在CT引導(dǎo)下細(xì)針穿刺,采用"兩步釋放法":將一小部分微彈簧圈釋放在病變附近5mm范圍內(nèi),一部分彈簧圈留在臟層胸膜表面,根據(jù)肺小結(jié)節(jié)及彈簧圈位置來確定切除結(jié)節(jié)周圍肺組織范圍,在胸腔鏡下行肺局部楔形切除,將離體組織進(jìn)行快速冰凍、組織學(xué)觀察,根據(jù)病變的良惡性指導(dǎo)臨床繼續(xù)擴(kuò)大手術(shù)或結(jié)束治療。結(jié)果 12例肺小結(jié)節(jié)行CT掃描均能清晰顯示病灶,置入彈簧圈,成功術(shù)前定位,并行胸腔鏡下肺楔形切除術(shù),全組患者手術(shù)順利,無嚴(yán)重手術(shù)并發(fā)癥和圍手術(shù)期死亡,術(shù)后病理診斷:原發(fā)性肺癌4例(33.3%),不典型腺瘤樣增生2例(16.7%),錯(cuò)構(gòu)瘤1例(8.3%),炎性病變5例(41.7%)。結(jié)論 CT引導(dǎo)下定位置入微彈簧圈在肺內(nèi)小結(jié)節(jié)楔形切除術(shù)中的應(yīng)用是安全、有效的,可以幫助胸外科醫(yī)師與病理醫(yī)師快速、準(zhǔn)確找到病灶,指導(dǎo)臨床治療。
[Abstract]:Objective to investigate the effect of CT guided microcoil placement in small pulmonary nodules wedge resection of the clinical application of intraoperative. Methods 12 cases of pulmonary nodules in patients with CT guided fine-needle aspiration, using "two step release": a small part of microcoil release in the lesions near the 5mm range, a part of spring circle in the visceral pleural surface, according to small pulmonary nodules and coil position to determine the resected nodules surrounding lung resection range in thoracoscopic pulmonary wedge, isolated tissues were frozen, histological observation, under the guidance of clinical benign and malignant lesions continue to expand the operation or the end of treatment. Results 12 cases of pulmonary nodules section CT scan can clearly show the lesions in coils, successful preoperative localization, parallel thoracoscopic pulmonary wedge resection surgery, all patients smoothly, there were no serious complications and no perioperative death, postoperative pathological diagnosis: Primary lung cancer in 4 cases (33.3%), 2 cases of atypical adenomatous hyperplasia (16.7%), 1 cases of hamartoma (8.3%), 5 cases of inflammatory lesions (41.7%). Conclusion CT guided microcoil placement in small pulmonary nodules wedge resection is safe and effective, can help Department of thoracic surgery physicians and pathologists quickly and accurately find the lesion, guide the clinical treatment.

【作者單位】： 北京市海淀醫(yī)院放射科;北京市海淀醫(yī)院胸外科;
【分類號(hào)】：R655.3;R816.41

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